The Center for Clinical Epidemiology and Biostatistics (CCEB) and the Gastroenterology Division (GD) at the University of Pennsylvania School of Medicine and the University's Leonard Davis Institute (LDI) are seeking the continuation of a highly successful research training program for clinically oriented investigators in Gastrointestinal Clinical Epidemiology. The overriding objective of this program is to train individuals who have completed their clinical training in a relevant medical specialty (e.g., gastroenterology and hepatology, general internal medicine, general surgery) to be rigorous and independent academic investigators skilled in the use of the range of gastrointestinal epidemiology and health services research approaches, methods and techniques. Completion of this training program provides trainees with the capacity to conduct rigorous, critical, hypothesis-driven research in the field of gastroenterology addressing issues of prognosis, prevention, diagnosis and early detection, treatment, decision making, technology assessment (outcomes and effectiveness research), health care economics, and quality of care. This two to three-year training program consists of: 1) a core curriculum of required courses in clinical epidemiology and health services research methodology and biostatistics; 2) a new series of seminars in gastroenterology combining faculty expertise from the CCEB, GD, and LDI; 3) extensive independent readings and individualized preceptorials; 4) participation in CCEB, GD, and LDI research seminars and journal clubs; and 5) completion of an independent research project in gastroenterology/hepatology clinical epidemiology conducted with guidance from and under the supervision of a mentored advisory panel. The program is designed to: 1) provide in-depth knowledge of the research techniques appropriate for clinical epidemiology and clinically-oriented health services research investigation; 2) provide innovative opportunities for research of topics related to gastroenterology/hepatology; 3) provide exposure to and experience with mentors in clinical epidemiology and gastroenterology/hepatology research; and 4) promote integration and cohesiveness between faculty and fellows through participation in CCEB, GD, and LDI lectures, seminars, and journal clubs. Fellows will be candidates for an MS degree in Clinical Epidemiology, a program with a rigorous approach analogous to obtaining a PhD degree. When feasible and appropriate, candidates will be encouraged to seek a PhD degree, building upon the foundation provided by the MS degree program. The strengths of the current Gastroenterology Clinical Epidemiology Training Program are a long history of successful NIH T32 research training programs in the CCEB, GD, and LDI; comprehensive and rigorous courses, seminars, and research programs for trainees; and a rich history of collaborative links among the programs. In addition, there are excellent basic science laboratories in the GD (supported by a combination of R01 grant funded investigators and an NIH/NIDDK Center for Digestive and Liver Diseases) and the Penn medical center, several large databases and tissue banks, and a deep commitment of all School of Medicine Chairpersons and Program Directors to the successful implementation of this training grant. The existence of a K30 grant (Clinical Research Curriculum Award), diverse faculty expertise in the CCEB, GD, and LDI, and recent successes of trainees all provide a strong rationale for the continuation and expansion of this program.